The Department of Health and Human Services released in the Federal Register "Changes to the Inpatient Rehabilitation Facility Prospective Payment System and FY 2004 Rates". In this Federal Register announcement, CMS clarified that recreational therapy services provided within an inpatient rehabilitation facility are a covered service therefore should be provided when medically indicated. The announcement clarifies ATRA's long-standing position that recreational therapy services are a covered service, when provided under the supervision of a physician and meets the definitions of active treatment. According to ATRA President Thompson, "This clarification by CMS will assure that Medicare beneficiaries have access to the full mix of cost-effective rehabilitation interventions including Recreational Therapy."

CMS stated "Neither the implementation of the prospective payment system nor the criteria for excluding certain hospitals and units from it will prohibit the provision of recreational therapy services to hospital inpatients." CMS further clarified, "Since the publication of the January 3, 1984 final rule, we have not made any changes to our policies that would preclude recreational therapy services from those covered by Medicare. In particular the introduction of the IRF PPS does not change this fact. Accordingly, since recreational therapy services were provided in the IRF base period, the costs of providing these covered services are included in standardized payment amount upon which the IRF PPS rates are based."

This is a huge victory for ATRA and most importantly to the clients that will be assured greater access to recreational therapy services in an inpatient rehabilitation setting. According to ATRA's Executive director, Ann Huston, This is the first of many successes to come.

The direct link to the CMS website IRF-PPS Final Rule is available at: http://www.cms.hhs.gov/PROVIDERS/IRFPPS/. For more information, please contact the ATRA National Office at (703) 683-9420 or at www.atra-tr.org .